- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,975.30 / $14,519.10 / $16,739.70
| Facility | | $11,975.30 | $14,519.10 | $16,739.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,169.50 / $16,169.50 / $16,169.50
| Facility | | $16,169.50 | $16,169.50 | $16,169.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,252.00 / $3,485.00 / $5,462.00
| Facility | | $1,252.00 | $3,485.00 | $5,462.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,652.86 / $16,956.41 / $29,102.51
| Facility | | $10,652.86 | $16,956.41 | $29,102.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $5,310.00 / $25,205.03
| Facility | | $2,332.00 | $5,310.00 | $25,205.03 |